2017 Maine Question 2

Maine Question 2, formally titled "An Act To Enhance Access to Affordable Health Care", is a citizen-initiated ballot measure that has qualified for the November 7, 2017 statewide ballot. It seeks to expand Medicaid eligibility under the terms of the Affordable Care Act, something which has been vetoed six times by Maine Gov. Paul LePage.

Unofficial results have the referendum passing with 59% of the vote. Gov. LePage had said that he would not implement the expansion unless it was funded by the legislature in a way that meets his criteria, although a state court had ordered his administration to carry it out. His successor as governor, Janet Mills, signed an order to implement the expansion as one of her first acts as governor.

Maine Republican Gov. Paul LePage has long been critical of the eligibility requirements for MaineCare, feeling that it was too easy to qualify for as it existed when he took office in 2010.[4] He was a staunch opponent of the Affordable Care Act, believing it to be unconstitutional and taking freedom from citizens.[5] LePage vetoed six efforts to expand MaineCare eligibility[6] and on one occasion called efforts by the Maine Legislature to write an expansion bill that would garner bipartisan support as having "no compassion".[7]

Supporters of expansion, led by Maine Equal Justice Partners, announced on October 12, 2016, their intent to launch a petition drive to put the issue to voters in a referendum, which the governor cannot veto if passed. LePage's spokesperson criticized the effort as "another attempt by liberals to pass welfare expansion".[8]

Maine Secretary of StateMatthew Dunlap announced on February 21, 2017, that supporters of the measure submitted over 66,000 verified signatures, far above the 61,123 required to place a measure on the ballot.[6]

The question that appeared on petition forms was "Do you want Maine to provide health insurance through Medicaid for qualified adults under the age of 65 with incomes at or below 138 percent of the federal poverty line?". During the comment period before the question's wording was finalized, several Republican legislators disputed the inclusion of the word "insurance" in the question, stating that in their view MaineCare benefits are not insurance, but welfare benefits. As such, in their view it would not meet the Maine Constitution's requirement that referendum questions be "simple, clear, concise, and direct". They further noted that the word insurance does not appear in the proposed referendum itself. Supporters defended the use of "insurance" as MaineCare does not provide cash to recipients, but pays providers of medical services directly.[9] At the end of the comment period, Secretary Dunlap announced that the final wording of the question would replace the word "insurance" with "coverage". Representatives of both sides of the issue announced their support of the decision.[10]

Results

Unofficial results as of election night have the referendum passing with 59% support to 41% in opposition.[17]

Gov. LePage has stated that he will not implement the expansion unless the legislature funds it without a tax increase or using money from the state Rainy Day Fund. There is also disagreement as to how much money the expansion will actually cost, with different estimates from Maine DHHS, the legislature, and supporters who call those estimates flawed. Republican candidates for governor Mary Mayhew and Kenneth Fredette (who is also House Minority Leader) are critical of the expansion, stating that Mainers did not fully consider the costs involved or taxes needed to pay for it. Democrats called for the law to be implemented and stated that they "will not give an inch in this fight", although they cannot provide funding on their own. The law can remain on the books even if not funded, and it was an issue in the 2018 elections. Democratic gubernatorial candidate Janet Mills stated she would implement the law, and Republican Shawn Moody stated he would continue LePage's refusal to do so.[18][19]

Supporters of expansion sued the LePage administration on April 30, 2018, to force the expansion to be implemented. Judge Michaela Murphy ruled on June 4, 2018, that Maine Department of Health and Human Services Commissioner Ricker Hamilton must submit a plan for expansion as the law requires by June 11 so that MaineCare can start accepting newly eligible applicants on July 2. Lawyers for supporters argued that MaineCare has sufficient funds already for the current fiscal year, and there are also $140 million in unallocated funds elsewhere in the budget if necessary.[20] LePage has said he would rather go to jail than implement the expansion without a funding mechanism that meets his criteria.[21]

LePage's successor, Democrat Janet Mills, signed an order to implement the referendum as one of her first acts, enabling signups to begin immediately.[19]

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